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:r <br />1~JI <br />Permit No: 81-44 <br />Anniversary Date: Apz~il 7 <br />Operator: <br /> <br />APR 1 4 1983 <br />ARINED LAND 17Err f.,•-~ rrOnJ <br />CDto. Dept. of Maiu~dr h,., o~rr.F- <br />Please complete the f~~Ilowing and return this form with your fees and reclamation <br />data. <br />Enclosed are: (Check box(es)) <br />Chuck or money order payable to Colorado Mined Land <br />CL-VIJ Reclamation Division for annual fees due <br />Annual Report <br />Remarks <br />Signed, <br /> <br />~.~-~'~ <br />.La L •;~ <br />1% . . ~ /, ~ <br />